A head-to-head comparison finds a winner—but there’s more you should know.

By Kent Peterson
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Kent Peterson, senior editor, has also produced award-winning work in television and radio.

Even with life-saving diabetes medicines, there can be too much of a good thing.

If more insulin ends up in the bloodstream than your body needs, blood sugar levels can plummet. This condition, called hypoglycemia, could be dangerous or even deadly. New research suggests that people with diabetes who take insulin may have fewer hypoglycemic episodes if they use insulin degludec .

How insulin helps

A healthy body makes its own insulin to keep blood sugar levels stable. People with diabetes can’t make enough insulin or can’t use it properly. That’s where prescription insulin comes in. Long-acting insulin (also called basal or background insulin) works throughout the day to meet the body’s constant needs, while short-acting insulin is taken with meals to prevent food from causing blood glucose levels to spike.

Every day, most people with type 1 diabetes use some combination of long- and short-acting insulin. Most people with type 2 diabetes will eventually need insulin too.

Different studies, similar results

Two separate double-blind studies, dubbed SWITCH 1 and SWITCH 2, set out to compare two long-acting insulins: insulin degludec, sold under the name brand Tresiba, and insulin glargine, sold as Basaglar, Lantus, and Toujeo. SWITCH 1 studied adults with type 1 diabetes, who were given one of the insulins every day for 32 weeks then switched to the other for 32 weeks. SWITCH 2 did the same with individuals who have type 2 diabetes. In all, about 1,200 people took part.

Both studies tallied three results:

The total number of hypoglycemia episodes that either dropped blood glucose levels below 56 mg/dL or caused symptoms requiring attention

The number of episodes that occurred overnight

How many episodes were considered severe

In SWITCH 1, type 1 insulin degludec users had rate reductions of 11 percent, 36 percent, and 35 percent respectively, compared with insulin glargine users. Results were even more impressive in the SWITCH 2 trial, with corresponding reductions of 30, 42, and 51 percent in people with type 2 diabetes. Insulin degludec outperformed the competition.

Every study has limits

Even well-constructed trials like the SWITCH studies have limitations you should consider. Among them in this case:

A common daily insulin dose called U-100 was used; study results may not apply to other dosages.

Both studies were paid for by Novo Nordisk, which markets insulin degludec products.

Dealing with your lows

Hypoglycemia is most common in people with type 1 diabetes, but everyone who uses insulin should learn the symptoms and take steps to avoid and treat lows. Talk with your doctor about whether it makes sense to change your basal insulin. If you switch, monitor the results because your body may respond differently than someone else’s does to this or any medicine.

Have you noticed a difference in basal insulins? Share your experience by commenting below.